Launch HN: Axle Health (YC W21) – In-Home Healthcare as a Service
Hey everyone,

We’re Connor and Adam and we’re working on Axle Health (https://www.axlehealth.com).

We provide an API for sending health professionals to people’s homes to deliver medical services. For example, a telehealth company can use our service to request an in-home blood draw for their patient.

Healthcare has traditionally been delivered in an office or hospital. In recent years, telehealth - providing healthcare remotely, without the need for people to come to a healthcare facility - has taken off as technology has improved, but physical tests are still often needed to make
diagnoses, and physical contact is needed to administer treatment. Without physical interaction, telehealth physicians can only handle a subset of common visit reasons. In all other cases they’re required to refer patients to a lab or in-person doctor. As a result of this lack of continuity in the patient’s care journey, most use telehealth platforms for one-off needs like getting a prescription filled. The goal of our platform is to be an extension of the physician in the patient’s home, working on the doctor’s orders to administer physical services that would normally require a visit to a lab or office.

I ran across this problem when I moved from New York to Los Angeles. I had received the first dose of a vaccine (not the COVID vaccine, unfortunately) before moving and needed the second on arrival. My only option was to find a new doctor who required me to do a full physical exam before I could receive the second dose. I did it, but needed to take a couple hours off of work. I thought “why can’t I just get this done at home”. It’s not just me, studies show that completion of multi-dose vaccine courses is as low as 33%. Life just gets in the way.

After I had my experience, I called up my friend from college, Adam, who worked at UberEats and we started thinking about the economics of bringing care to patients’ homes. The wealthy already have access to in-home healthcare. The question was, could we drive enough operational efficiency and optimization to make this available to everyone while only charging a small per visit fee for companies to use the platform. Solving this problem would have far reaching implications by expanding access to treatment in healthcare deserts, enabling decentralized clinical trials, improving uptake of basic preventive services, and leading to better health outcomes.

The operational and technical challenge of sending a health professional to a patient’s home is complex. There are a couple of old line national phlebotomy companies that go in-home, but phlebotomy (drawing blood) is the easy part. When you start moving up the licensure ladder from phlebotomist to medical assistant to licensed practical nurse to registered nurse, their scope of practice expands. Each state has its own laws governing the scope of practice of each of those professionals. For example, our appointment assignment algorithm needs to account for the fact that in Florida a medical assistant can start an IV line, but in California they can’t. We need to ensure each professional has the right mix of supplies for their daily appointments to drive maximum efficiency - a nurse might go from administering an immunotherapy IV at one home to a vaccine at another. Luckily Adam is crazy enough to like these logistical headaches :P

But, Adam won’t need to solve these problems manually. We’ve built a good bit of software around matching patients with in-home professionals. The process is fully programmatic meaning partners can use our API to find available services in a zip code, pull time slot availability and pricing by geography, indicate special instructions from the doctor, book visits, and receive visit updates via webhooks. Health professionals from our network use the Axle app to get shift assignments, indicate to patients that they’re en route, and write up any visit notes. Patients can even see their health professional on a map in real time just like an Uber. We want to make the process of getting in-home care as seamless as possible for patients and health professionals.

Our API documentation (https://developers.axlehealth.com) is publicly available. We’re hoping to enable the next generation of healthcare startups by offering them the ability to physically interact with patients, through us. We wanted to make the API as straightforward as possible, so we welcome any feedback on the documentation or our product at large!

Thanks for reading!